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Biomedical subjects

M Endo

Publications and source records attributed to M Endo.

At least 145 records · Page 8Linked to original sources
PubMed2000

Feasibility study of autologous peripheral blood stem cell transplantation for the treatment of childhood acute myelogenous leukemia.

BACKGROUND: The primary object of this study was to identify treatment-related variables that may predict relapse of acute myelogenous leukemia (AML) after autologous peripheral blood stem cell transplantation (PBSCT), which will be critical for the development of a suitable protocol for wider application. METHODS: A total of 28 children (age 0-18 years) with AML underwent PBSCT and have had a minimum follow-up of 25 months; including 24 patients in their first complete remission (CR) and four in their second CR. The patients were divided into two cohorts according to the study phase: 16 patients were treated in an early phase pilot study and 12 patients in their first CR were treated in a prospective trial. Fifteen of the first-CR patients had any of the cited high-risk features of high WBC count (>100x10(9)/l; n = 5), FAB M0/M4/M5/M7 subtypes (n = 11) or delayed achievement of CR (n = 9). Except in one patient, cytoreductive regimens did not include total body irradiation (TBI). RESULTS: After PBSCT, one patient died of veno-occulsive disease (VOD) and another patient relapsed early on day 43, but the remaining patients showed engraftment. Leukemic relapse was observed 1-29 months after PBSCT (median, 8 months); in all of the 4 children treated in their second CR and in 11 of the 24 patients (46%) treated in their first CR. The remaining patients have been disease-free for 24 to 97 months (median, 53 months). Using a multivariate analysis, the timing of apheresis was the most significant prognostic factor for those treated in their first CR (p = 0.03); 12 of the 16 patients whose PBSC were collected beyond 2.5 months of CR continue to remain in CR, while seven of the eight patients whose PBSC were harvested within 2.5 months of CR relapsed. CONCLUSION: Although the small number of patients studied does not allow firm conclusions to be drawn regarding the relative effectiveness of this therapy, the results do suggest the feasibility of further studies of PBSCT for the treatment of childhood AML with high-risk features including the assessment of minimum residual disease.

Adolescent↗
PubMed2000

Chimeric glycosaminoglycan oligosaccharides synthesized by enzymatic reconstruction and their use in substrate specificity determination of Streptococcus hyaluronidase.

A method was developed for the reconstruction of glycosaminoglycan (GAG) oligosaccharides using the transglycosylation reaction of an endo-beta-N-acetylhexosaminidase, testicular hyaluronidase, under optimal conditions. Repetition of the transglycosylation using suitable combinations of various GAGs as acceptors and donors made it possible to custom-synthesize GAG oligosaccharides. Thus we prepared a library of chimeric GAG oligosaccharides with hybrid structures composed of disaccharide units such as GlcA-GlcNAc (from hyaluronic acid), GlcA-GalNAc (from chondroitin), GlcA-GalNAc4S (from chondroitin 4-sulfate), GlcA-GalNAc6S (from chondroitin 6-sulfate), IdoA-GalNAc (from desulfated dermatan sulfate), and GlcA-GalNAc4,6-diS (from chondroitin sulfate E). The specificity of the hyaluronidase from Streptococcus dysgalactiae (hyaluronidase SD) was then investigated using these chimeric GAG oligosaccharides as model substrates. The results indicate that the specificity of hyaluronidase SD is determined by the following restrictions at the nonreducing terminal side of the cleavage site: (i) at least one disaccharide unit (GlcA-GlcNAc) is necessary for the enzymatic action of hyaluronidase SD; (ii) cleavage is inhibited by sulfation of the N-acetylgalactosamine; (iii) hyaluronidase SD releases GlcA-GalNAc and IdoA-GalNAc units as well as GlcA-GlcNAc. At the reducing terminal side of the cleavage site, the sulfated residues on the N-acetylgalactosamines in the disaccharide units were found to have no influence on the cleavage. Additionally, we found that hyaluronidase SD can specifically and endolytically cleave the internal unsulfated regions of chondroitin sulfate chains. This demonstration indicates that custom-synthesized GAG oligosaccharides will open a new avenue in GAG glycotechnology.

Animals↗
PubMed2000

Sensitive enzyme-linked immunosorbent assays for the detection of bacterial superantigens and antibodies against them in human plasma.

Enzyme-linked immunosorbent assays for the quantitation of bacterial superantigens, staphylococcal enterotoxins A, B and C, toxic-shock syndrome toxin-1 and streptococcal pyrogenic exotoxin A, were developed. The assays had sensitivity to quantitate these toxins to 1.4, 5.9, 16.3, 2.5 and 4.3 pg/ml, respectively, in a buffer including 50% human plasma. It takes only 150 min to complete the assays after plate preparation. Specificity of the assays agreed with those of reverse latex agglutination assay. We also developed enzyme-linked immunosorbent assays to detect antibodies against these five superantigens. The assays are expected to be significant tools for the study of superantigens in several diseases.

Animals↗
PubMed2000

CD4(+)-T-Cell-mediated resistance to systemic murine candidiasis induced by a membrane fraction of Candida albicans.

We induced resistance to systemic Candida albicans infection through CD4(+)-cell-mediated immunity in mice by immunization with subcutaneous injections of live C. albicans cells emulsified in incomplete Freund adjuvant. Using the resistant mice, we tested subcellular fractions of C. albicans cells for antigenicity. The fractions were derived from digested surface cell walls, insoluble membranes, or soluble and insoluble cytoplasmic materials, which were prepared by treatment with cell wall-digesting enzymes followed by lysis of the consequent protoplasts. Interestingly, the live-cell-immunized mice showed strong cell-mediated immune responses to the membrane fraction (C. albicans membrane antigen [CMA]). In addition, immunization with CMA induced resistance to systemic candidiasis, which disappeared upon administration of anti-CD4 monoclonal antibody. Infusion of splenocytes from the CMA-immunized mice conferred resistance on SCID mice, whereas infusion of CD4(+)-T-cell-depleted splenocytes was unable to induce resistance, indicating the importance of CD4(+) lymphocytes for resistance. These results suggest a potential for the membrane fraction to act as an antigen conferring resistance to systemic candidiasis in place of live cells and also as a source for the isolation of a new antigen.

Adoptive Transfer↗
PubMed2000

Immunization with the Candida albicans membrane fraction and in combination with fluconazole protects against systemic fungal infections.

We studied the immunogenicity of a membrane fraction prepared from Candida albicans cells called C. albicans membrane antigen (CMA). The present study revealed that CMA immunization has antifungal activity in mouse models of systemic fungal infection. Immunization of mice by subcutaneous injections of CMA with incomplete Freund adjuvant induced resistance to infections caused not only by C. albicans but also by Aspergillus fumigatus. The level of resistance to candidiasis was as high as that induced by whole-cell immunization. The acquired resistance to candidiasis in the mice immunized with CMA was not diminished by immunosuppressive treatment with cyclophosphamide. The level of resistance to fungal infections was superior to that given by fluconazole (FLC) treatment alone and highly enhanced by the combination with FLC. When CD4(+) cells in CMA-immunized mice were depleted by a monoclonal antibody, the antifungal activity induced by the combination of CMA and FLC was significantly reduced. These results indicate that immunization with CMA is useful for preventing systemic fungal infections and in combination with FLC for increasing resistance after infection.

Animals↗
PubMed2000

[Late results of SJM and CM valves in bentall procedure].

Recently, Bentall procedure is commonly performed for annuloaortic ectasia with aortic regurgitation or dissecting aneurysm. And the operative results are improving. In this study, we evaluated results of the St. Jude Medical (SJM) and Carbomedics (CM) valves which were used in this procedure. From 1979 to 1994, 87 SJM valves and 22 CM valves were implanted in the aortic position of Bentall procedure. Total follow-up was 528.6 years in the SJM group and 56.5 years in the CM group. According to the Kaplan-Meier actuarial method and the Cox-Mantel statistical analysis, actuarial survival, thromboembolism free rate, reoperation free rate, event free rate were not different between the SJM and CM groups. These results suggest that, current selection of the SJM and CM valves would be acceptable in Bentall procedure.

Adult↗
PubMed2000

[Anesthetic management for a patient with autoimmune hemolytic anemia].

A 69-year-old woman with autoimmune hemolytic anemia (AIHA) received gastric resection and splenectomy under general anesthesia combined with epidural anesthesia. Her blood type had been determined as type A, Rh type CCDee, with anti-e-antibody and anti-pdl-antibody positive as autoantibodies. We applied the technique of hemodilutional autologous transfusion to supplement the blood loss during the operation to prevent hemolysis or occurrence of new antibody after homologous transfusion. We should pay much attention to a patient with AIHA to find signs of peri-operative hemolysis and to give the treatment for hemolysis in early stage. We consider that the hemodilutional autologous transfusion is a useful technique for the anesthetic management of the patient having a rare blood type.

Aged↗
PubMed2000

[Open heart surgery in three patients receiving dialysis for more than 20 years].

In Japan, the number of chronic hemodialysis (HD) patients is increasing, and there are 7,000 cases with a more than 20 year history of HD. At our institute, we have experienced 135 cases of open heart surgery in patients on HD, including 92 isolated CABG cases and 43 other open heart surgery cases. However, open heart surgery for patients with a more than 20 year history on HD is rare. Open heart surgery on HD patients is rather difficult, since perioperative management can be complicated and special care must be taken for prophylaxis of infection, fluid and electrolyte management and anticoagulation therapy. Many complications have been published in HD patients. At our institute, 3 cases of open heart surgery in patients with more than a 20 year history of HD have been performed. These included triple CABG, double CABG + AVR and double CABG in a post-kidney transplantation patient. They were discharged uneventfully with angiographically patent grafts. It is concluded that for CABG in patients on HD, aggressive use of arterial conduits for revascularization is recommended. For patients with a transplanted kidney, careful management against dysfunction and rejection is necessary.

Angina, Unstable↗
PubMed2000

[Four cases of third time operation of coronary artery bypass grafting].

Reoperative coronary artery bypass operations are increasing in frequency. Consequently, an ever-increasing pool of patients now is being seen with need of coronary revascularization for repeated time. Four cases of second reoperation were retrospectively investigated. Until March 1999, 2,563 cases of isolated coronary artery bypass grafting were done at the Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan. Within those cases, 124 cases (4.8%) were reoperated. And among those 124 cases, 4 cases (3.2%) were secondly reoperated. There were one hospital death and two had a perioperative myocardial infarction. All of them needed intraaortic balloon pump support after operation. Three were discharged with relief of the symptoms. The average age at the primary operation was 51.1 years. All these cases, at the primary operation, no ITA graft was used. Two cases were incompletely revascularized, because of coronary arteries were ungraftable. Both at reoperation and at second reoperation, we are trying to make a complete revascularization by all arterial grafts. But because of limited number of arterial graft at repeated operation, all arterial complete revascularization is not done without difficulty. Therefore it is concluded that saphenous vein graft is still needed at repeated operation.

Aged↗
PubMed2000

[Early and late results of combined valvular and coronary artery operations].

A total of 122 patients with ischemic heart disease underwent valvular surgery. Thirty-nine had combined CABG and aortic valve surgery (included Bentall method), 72 had CABG and mitral valve operations, and 8 patients had CABG and double or triple valve operations. Only 3 patients for ruptured papillary muscle due to acute myocardial infarction had isolated mitral valve replacement. Early mortality was 5.1% AV, 2.8% MV and 12.5% DTV in the combined groups and 0% in the valve only group. The grafts patency rate was 93.5%. Univariate analysis of risk factors selected in the dialysis patients and the patients age older than 65 years as the strongest predictors for early death. At the mean follow up period of 5.4 +/- 4.8 year after surgery, the 5-year all death free rates were 57.9 +/- 9.6% AV, 69.6 +/- 5.8% MV and 75.0 +/- 15.3% DTV. The 5-year cardiac death free rates were 73.8 +/- 9.0% AV, 77.5 +/- 5.4% MD and 75.0 +/- 15.3% DTV.

Adolescent↗
PubMed2000

Re-use of left internal thoracic artery for redo operation after MIDCAB.

We report a case of recycling of left internal thoracic artery (LITA) in situ in reoperation of coronary artery bypass grafting. A 41-year-old male, who has poor-controlled hypercholesterolemia, was bypassed LITA to the left anterior descending artery (LAD) in minimally invasive direct coronary artery bypass (MIDCAB) manner at the other hospital. Four months later, he felt short of breath on effort. Coronary angiogram showed stenoses of the left main trunk and anastomosis site of the LITA. At redo operation, we skeletonised the LITA and reused it in situ to the LAD. Using the skeletonised method for re-harvesting LITA made the graft reach a more distal portion without tension. He is doing well at 18 months after surgery. In selected patients, recycling of the used arterial grafts can reserve other arterial grafts for redo operations in the future.

Adult↗
PubMed2000

[Monitoring of the cryptococcus count in the cerebrospinal fluid with negative cultures in two cases of serious cryptococcal meningitis].

We monitored the cryptococcus count in the cerebrospinal fluid(CSF) using the filter technique in two cases of serious cryptococcal meningitis during the course of treatment with antifungal agents. Lumbar puncture was performed once a week, and 1 ml of CSF was filtered through a Millipore filter(5.0-micron pore for cells), followed by staining of the filters with Alcian blue. All of the cryptococci on the filter were counted under a light microscope at a magnification of x 100. More than 500/ml and 2,000/ml of cryptococci were still observed in the CFS in Cases 1 and 2, respectively, in whom CFS cultures for Cryptococcus neoformans became negative after 4 weeks of treatment. Even though the treatment with antifungal agents were continued in these cases, cryptococci could still be observed for 5 weeks and 60 weeks on the filter preparations of Cases 1 and 2, respectively, after the CSF cultures became negative. The cryptococcal antigen could also be detected in the CSF during the positive filter preparations in these cases. At autopsy in Case 2, patchy lepromeningeal inflammatory lesions with the characteristic capsules of cryptococci were observed in the subarachnoid space. These observations suggest that cryptococci, which persisted in the CSF despite the negative cultures, were responsible for the lesions in the subarachnoid space and protracted clinical course in the two cases of cryptococcal meningitis.

Aged↗
PubMed2000

[Long-term maintenance treatment of reflux esophagitis resistant to H2-RA with PPI (lansoprazole)].

97 patients in 49 hospitals with erosive esophagitis unhealed after at least 8 weeks treatment with H2-RA were given primary treatment with 30 mg lansoprazol once daily. After 8 weeks of treatment with lansoprazol, 75(77%) patients were endoscopically healed. Healed patients were then given maintenance treatment with either 30 mg lansoprazol once daily, 15 mg lansoprazol once daily or 20 mg famotidine twice daily for 24 weeks. 86% of patients randomized to 30 mg lansoprazol, 70% of patients randomized to 15 mg lansoprazol were maintained in endoscopic healing throughout 24 weeks as compared with only 12% of patients randomized to famotidine in endoscopic healing. After 24 weeks of lansoprazol treatment basal gastrin levels were moderately increased. However no significant histopathologic lesion was found in the oxyntic gland mucosa. PPI(lansoprazol) was far superior to H2-RA(famotidine) in preventing recurrence of healed erosive esophagitis. A goal achieved without adverse events and significant abnormalities in the oxyntic mucosal exocrine or endocrine cell but a moderate increase in basal gastrine levels.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2000

[Serum anti-arrestin antibody and disease activity of multiple sclerosis--a case report of 4-year-old child].

We report a 4-year-old girl with multiple sclerosis (MS) and increased serum anti-arrestin antibody. She was admitted to our hospital because of sustained fever, headache and anorexia. Serial magnetic resonance imaging (MRI) revealed diffuse high intensity of cerebral white matter and basal ganglia on T2-weighted imaging. We treated her with high-dose intravenous methylprednisolone under a diagnosis of ADEM. She recovered without any neurological sequelae in three months and the MRI lesion almost disappeared. However, she developed optic neuritis and two episodes of neurologic involvement associated with multiple white matter lesions in the next two years. She was then diagnosed as having clinically definite MS. Anti-arrestin antibody is reportedly present specifically in adult patients with MS and uveitis. We performed an immunoblot assay using bovine retina, and our case revealed the presence of anti-arrestin antibody. Serial examinations showed that the serum anti-arrestin antibody titer correlated well with the disease activity. These results indicate that anti-arrestin antibody may be a good parameter of the disease activity of MS even in childhood.

Arrestin↗
PubMed2000

Binocular cross-orientation suppression in the primary visual cortex (V1) of infant rhesus monkeys.

PURPOSE: To better understand the course of cortical maturation during early development, the phenomenon of binocular cross-orientation suppression in neurons of the primary visual cortex (V1) in young infant monkeys was investigated. METHODS: Extracellular single-unit recordings were made in anesthetized and paralyzed monkeys ranging in age between 6 days and 8 weeks. Orthogonally oriented, dichoptic sine-wave gratings were used as visual stimuli. RESULTS: V1 neurons in young infant monkeys showed a higher prevalence and greater magnitude of binocular cross-orientation suppression than in adult monkeys. Binocular suppression decreased and reached an adult level between 4 and 8 weeks of age, the presumed onset-age for stereopsis in monkeys. CONCLUSIONS: During the first 4 weeks of life, the functional connections that are necessary for initiating binocular cross-orientation suppression exist in the monkey primary visual cortex. This finding is consistent with the view that before the abrupt onset of stereopsis, human infants may detect the differences between interocularly iso-oriented gratings and orthogonal gratings.

Aging↗
PubMed2000

[Recent surgical treatment for patients with true aortic arch aneurysm].

From december 1996 to april 1999, 25 patients with true aortic arch aneurysm underwent aortic arch aneurysm repair using selective cerebral perfusion. There were 17 males and 8 females ranging in age from 62 to 79 years (mean 71 years). Orikaesi method was used in the procedure of distal anastomosis for complete aortic arch replacement with a prosthetic graft. This technique allowed us a simple approach to the lesion and the easy additional stitch. The average duration of extracorporeal circulation, aortic crossclamping, selective cerebral perfusion were 269 minutes, 140 minutes, and 122 minutes, respectively, under 19.3 degrees C of lowest esophageal temperature. There were no cases complicated with postoperative low output syndrome and cerebrovascular accident, and no hospital mortality. Replacement of the aortic arch using selective cerebral perfusion is a safe procedure with acceptable hospital mortality.

Aged↗